Aspectos anatômicos e funcionais da língua após frenectomia em gemelares: relato de casos clínicos / Anatomic and functional aspects of the tongue after frenectomy in twin: clinical cases report

Objetivo: Relatar dois casos clínicos de alteração de frênulo lingual em gemelares, com 10 anos de idade, ambas do sexo feminino, avaliadas nos aspectos anatômicos e funcionais da língua antes e 15 dias após a frenectomia. Relato de casos: Inicialmente, o odontopediatra realizou a anamnese com a mãe. Em seguida, as participantes foram submetidas à avaliação clínica odontológica e, posteriormente, foi realizada a avaliação fonoaudiológica do frênulo lingual. A avaliação fonoaudiológica foi realizada por meio do Protocolo de Avaliação do Frênulo da Língua, que foi aplicado antes e 15 dias após a frenectomia. As duas participantes apresentaram melhor desempenho em provas anatômicas após o procedimento cirúrgico. Entretanto, algumas alterações, principalmente ao elevar a língua, continuaram sendo observadas em uma das pacientes 15 dias após a frenectomia. Ademais, as duas participantes passaram a executar a maioria dos movimentos de língua com maior precisão. No que se refere à fala, somente a participante que apresentava um maior número de alterações fonéticas anteriores, permaneceu com algumas alterações na fala decorridos 15 dias da cirurgia. Discussão: Algumas dificuldades envolvendo mobilidade da língua e alterações na fala podem persistir após a realização da cirurgia, indicando a necessidade de intervenção fonoaudiológica específica. Conclusão: Ambos os casos apresentaram melhora no desempenho tanto nas provas anatômicas quanto funcionais após a frenectomia.

Aim: to report two clinical cases of alteration of the lingual frenulum in twins, aged 10 years, both female, evaluated in the anatomical and functional aspects of the tongue before and 15 days after the frenectomy. Case reports: Initially, the paediatric dentistry performed the anamnesis with the mother. Then, the participants were submitted to a dental clinical evaluation and, sub-sequently, the speech language pathologist evaluation of the lingual frenulum was performed. The speech language pathologist assessment was performed using the Tongue Frenulum Evaluation Protocol, which was applied before and 15 days after the frenectomy. Both participants performed better in anatomical tests after the surgical procedure. However, some changes, especially when elevating the tongue, continued to be observed in one of the patients 15 days after the frenectomy. In addition, the two participants started to perform most of the tongue movements with greater precision. About speech, only the participant who had a greater number of previous phonetic changes, remained with some speech disorders after 15 days of surgery. Discussion: Some di-fficulties involving mobility of the tongue and changes in speech may persist after surgery, indicating the need for specific speech therapy intervention. Conclusion:Both cases showed improvement in performance both in anatomical and functional tests after frenectomy

Community awareness of speech pathology: A regional perspective.

OBJECTIVE: Speech pathology has a history of low public awareness and in the absence of current research it is unclear if community awareness has changed in recent years. This study sought to explore a regional community's awareness of speech pathology as the impetus for considering future directions pertaining to awareness and understanding of the scope of practice of this profession. DESIGN: An anonymous online survey was created using questions from previously validated surveys on this topic, and then distributed via snowball sampling using social media. SETTING: Data are from residents of the Central Queensland community in Australia. PARTICIPANTS: Two hundred and seven adults who live in Central Queensland completed the survey. MAIN OUTCOME MEASURES: Comparisons were drawn between the responses from this survey to those from earlier studies. RESULTS: The majority of respondents had heard of speech pathology mostly due to personal contact, but they indicated that they did not know 'a lot' about speech pathology. Knowledgeable individuals had higher levels of education and were better able to identify speech pathologists' scope of practice. Personal contact with a speech pathologist also significantly contributed to self-rated knowledge and accurate identification of scope of practice of speech pathologists. CONCLUSION: While regional Central Queensland community members have heard of speech pathology, their self-reported knowledge of the profession continues to be low. In order to optimise service access and consumer outcomes it is recommended that the profession aims to improve community awareness of speech pathology.

Profile of users receiving Speech-Language Therapy service at a Critical Patient Unit / Perfil de usuarios que reciben atención fonoaudiológica en una unidad de paciente crítico

ABSTRACT Objective: to describe the profile of patients treated by Speech-Language therapists in a Critical Patient Unit. Methods: an ex post facto, observational and descriptive study was carried out. Monthly statistical data of patients hospitalized in the period January-December 2018 were analyzed, in the Intensive Care Unit at a public hospital. Data were described from the analysis of frequency and measures of central tendency. The distribution of the variables was determined through the skewness-kurtosis test, considering a significance level of p<0.05. Results: 217 individuals got 868 speech-language therapy services. Men (57.26%), older than 65 years old, required a more frequent intervention. The main medical diagnosis of admission to the unit corresponded to non-specific pathologies (57.14%), respiratory disease (15.21%) and cerebrovascular disease (12.79%). The speech-language therapy functions were related to the evaluation of swallowing (54.31%) and voice (32.4%). In relation to the intervention, the treatment of dysphagia (25.82%) and oral motor functions (25.04%) was predominant in the duties. Functions associated with language, speech and cognition were secondary. Conclusion: the profile of the critical patient and the speech-language therapy work in this field represent a first step to characterize the role of the speech-language therapist in Intensive Medicine teams.

RESUMEN Objetivo: describir el perfil de usuarios atendidos por fonoaudiólogos en una unidad de paciente crítico. Métodos: se realizó un estudio observacional descriptivo con temporalidad ex post facto. Se analizaron los resúmenes estadísticos mensuales de usuarios internados durante los meses de enero a diciembre de 2018, en la unidad de cuidados intensivos de un hospital público. Se describieron los datos a partir de análisis de frecuencia y medidas de tendencia central. La distribución de las variables se determinó mediante skewness-kurtosis test, considerando un nivel de significancia p<0,05. Resultados: 217 sujetos recibieron 868 atenciones fonoaudiológicas. Los hombres (57,26%) mayores de 65 años requirieron una intervención más frecuente. Los principales diagnósticos médicos de ingreso a la unidad correspondieron a patologías inespecíficas (57,14%), enfermedades respiratorias (15,21%) y cerebrovasculares (12,79%). Las funciones de fonoaudiología se relacionaron con la evaluación de la deglución (54,31%) y de la voz (32,4%). En cuanto a la intervención, el tratamiento de la disfagia (25,82%) y las funciones motoras orales (25,04%) dominaron la carga laboral. Las funciones asociadas con el lenguaje, el habla y la cognición fueron secundarias. Conclusión: el perfil del paciente crítico y las labores fonoaudiológicas en este ámbito representan un primer paso para caracterizar el rol profesional del fonoaudiólogo en el contexto de los equipos de medicina intensiva.

Validation and inter-rater reliability testing of the Arabic version of speech intelligibility rating among children with cochlear implant.

OBJECTIVES: To validate and assess the reliability of the new version of an Arabic speech intelligibility rating among di erent raters. METHODS: This cross-sectional analysis was carried out between December 2018 and January 2019. Thirty cochlear-implant (CI) children (study group) and 30 subjects (control group) were enrolled. Study candidates' speech skills were evaluated using the translated Arabic SIR by parents and original SIR by professions such as speech-language pathologists (SLPs). Inter-rater agreement, test-retest reliability, pre- and post-intervention score (responsiveness test), patient versus control score comparison (discriminant validity), and cross-validation of Arabic SIR have all been assessed. RESULTS: There was a good sense of agreement between the post-operative SIR parents' assessments and the professional SLPs' assessments (r=0.920, p less than 0.001). The mean of study subjects pre- and post-implantation score of Arabic SIR showed a statistically significant difference (p less than 0.001). CONCLUSION: The Arabic SIR demonstrated excellent reliability with strong consistency. It showed its clinical ability in distinguishing healthy subjects from patients along with follow up of speech development skills over time. The Arabic SIR can be used by parents to evaluate post-CI progress of their children.

Behavioral and neurological effects of tDCS on speech motor recovery: A single-subject intervention study.

This paper reports a feasibility study designed to evaluate the behavioral and neurological effects of using transcranial direct current stimulation (tDCS) in conjunction with speech motor learning treatment for individuals with acquired speech impairment subsequent to stroke. Most of the research using tDCS to enhance treatment outcomes in stroke recovery has focused on either limb motor control or aphasia treatment. Using a multiple-baseline multiple-probe crossover design, we compared both behavioral and brain connectivity-based outcomes following speech motor learning treatment with both Active tDCS and Sham tDCS. We observed that both treatment phases led to improvement in short-term maintenance, but that Active tDCS was associated with greater long-term maintenance improvement. Active tDCS was also associated with an increase in functional connectivity in the left hemisphere and interhemispherically in an ROI-based network analysis examining correlations among areas associated with speech production and acquired speech impairment. This report supports the possibility that tDCS may enhance both behavioral and neurological outcomes and indicates the importance of additional work in this area, although replication is required to confirm the extent and consistency of tDCS benefits on speech motor learning treatment outcomes.

Contributions of ICF to an integral approach in the Health Care for Children and Adolescents. / Contribuições da CIF para uma abordagem integral na atenção à Saúde de Crianças e Adolescentes.

PURPOSE: To investigate participation, and functionality of children and adolescents with speech disorders using the International Classification of Functioning, Disability and Health (ICF). METHOD: Descriptive and analytical research of qualitative and quantitative approach. The sample was composed of 30 participants with speech disorders and 30 with typical speech development. For data collection, it was conducted semi-structured interviews with the participants, medical record review, observation of speech aspects' participants, and analyzed study of medical records. The collected data were used to qualify the framework codes. The Mann-Whitney Test was used for comparison between groups, and thematic content analysis for the interviews. RESULTS: Participants with speech disorders reported more difficulties than the participants with typical speech development. Speech disorders significantly impacted on the Body Functions (articulation and fluency), Activities and Participation (conversation, relationships, carrying out the routine and handling of stress) and Environmental Factors (attitudes of family, friends and acquaintances). CONCLUSION: The results show the impact of speech disorders and their social consequences for these children and adolescents. The ICF allowed us to comprehend health in all its complexity and integrality, making possible to plan strategies to soften the disorders impact in an individual and collective perspective. Then, ICF can be used, in the future, for elaboration of public policies and actions that will improve the quality of life and promote the health of this population.

Immediate effects of voice focus adjustments on hypernasal speakers' nasalance scores.

OBJECTIVES: To explore the immediate effects of voice focus adjustments on the oral-nasal balance of hypernasal speakers, measured with nasalance scores. METHODS: Five hypernasal speakers (2 M, 3 F) aged 5-12 (SD 2.7) learned to speak with extreme forward and backward voice focus. Speakers repeated oral, nasal, and phonetically balanced stimuli. Nasalance scores were collected with the Nasometer 6450. RESULTS: From the average baseline of 34.27% for the oral stimulus, nasalance increased to 46.07% in forward and decreased to 30.2% in backward focus. From the average baseline of 64.53% for the nasal stimulus, nasalance decreased to 64.13% in forward and decreased to 51.73% in backward focus. From the average baseline of 51.33% for the phonetically balanced stimulus, nasalance increased to 58.87% in forward and decreased to 46.2% in backward focus. CONCLUSIONS: Forward voice focus resulted in higher and backward voice focus resulted in lower nasalance scores during speech for a group of hypernasal speakers. However, there was an exception: One male speaker showed decreased nasalance in forward voice focus. Future research should investigate the longer-term effectiveness of the intervention.

Optimizing speech outcomes for cleft palate.

PURPOSE OF REVIEW: Cleft lip with or without palate is one of the most common pediatric birth anomalies. Patients with cleft palate often have speech difficulties from underlying anatomical defects that can persist after surgery. This significantly impacts child development. There is a lack of evidence exploring, which surgical techniques optimize speech outcomes. The purpose of this update is to report on recent literature investigating how to optimize speech outcomes for cleft palate. RECENT FINDINGS: The two-flap palatoplasty with intravelar veloplasty (IVVP) and Furlow double-opposing Z-plasty has the strongest evidence for optimizing speech. One-stage palatal repair is favored at 10-14 months of age, while delays are associated with significant speech deficits. For postoperative speech deficits, there is no significant difference between the pharyngeal flap, sphincter pharyngoplasty, and posterior pharyngeal wall augmentation. Surgical management should be guided by closure pattern and velopharyngeal gap but few studies stratify by these characteristics. SUMMARY: According to recent evidence, the two-flap palatoplasty with IVVP and Furlow palatoplasty result in the best speech. The pharyngeal flap, sphincter pharyngoplasty, and posterior pharyngeal wall augmentation are all viable techniques to correct residual velopharyngeal insufficiency. Future research should focus on incorporating standardized measures and more robust study designs.

[Effect of physical rehabilitation in patients with hereditary spinocerebellar ataxia. A systematic review]. / Efecto de la rehabilitación física en pacientes con ataxia espinocerebelosa hereditaria. Una revisión sistemática.

Evidence of the effectiveness of rehabilitation interventions in spinocerebellar ataxia is scarce and variable. OBJECTIVES: The aim of this systematic review was to gather the existing evidence on the effectiveness of these interventions. MATERIAL AND METHODS: To do this, we analysed all the clinical trials published to date and assessed their results in terms of improved balance, gait, and performance of daily activities after treatment. Significant improvements were found for posture (P<.008) and gait (P<.02), as well as a reduction in the scores for the SARAg&p subscale (gait and posture) and SCAFI 8MW index (gait speed) (P=.02). We also observed improvements in speech disorders (P=.02), depressive symptoms (P<.0001) and accidental falls (P<.005).

The speech pathology workforce in intensive care units: Results from a national survey.

BACKGROUND: Admission to the intensive care unit (ICU) with mechanical ventilation can lead to patients experiencing impaired swallowing and communication function. This can negatively affect patient experiences and outcomes. There is increasing research supporting early intervention for swallowing and communication; however, there are no published ICU workforce data to determine patient access. PURPOSE: The purpose of this study was to describe national ICU access to speech pathology (SP) services and to describe the nature of this workforce. METHODS: Prospective audit of Australian ICUs with a focussed workforce survey of SP service including workforce demographics, clinical practices, team environments, and training was conducted. Data are described as percentage (%, n) and as median (interquartile range). Qualitative data were analysed using thematic frameworks. RESULTS: SP services were available at 99% (n = 165) of the sites; 62 sites provided workforce data (45% response rate). Seventy-one percent of respondents serviced the ICU ≤10 h per week, with 23% reporting dedicated funding. Almost a third (32%) reported not participating in ICU team activities, and more than half of the sites (56%) did not provide ICU-specific training with resulting varied clinical confidence ratings. Facilitator and barriers both highlighted team working relationships. Facilitator themes were building working relationships, understanding the SP role in the multidisciplinary team, physical presence in the unit, and access to resources. Barrier themes were the multidisciplinary team's understanding of SP roles and lack of presence of SP services in the ICU. CONCLUSIONS: SP services are not standard across Australian ICUs, with variations in confidence, funding, training, and team environments. Further research into the impact of these variations on patient outcomes is needed.

Contributions to Gain in Speech Sound Production Accuracy for Children With Speech Sound Disorders: Exploring Child and Therapy Factors.

Purpose The purpose of this study was to explore the extent to which child- and therapy-level factors contribute to gains in speech sound production accuracy for children with speech sound disorders in receipt of school-based services. Method Data were obtained from 126 kindergarten and first- and second-grade children currently in receipt of speech therapy services in their public school setting. Pretest and posttest measures of spontaneous speech production and language ability were collected at the beginning and end of one academic year. Using a spontaneous speech sample, percentage of consonants correct (PCC) was calculated for each child; a gain score was computed by subtracting the pretest PCC score from the posttest PCC score. The children's speech-language pathologist completed weekly therapy logs during business-as-usual therapy, indicating the frequency, duration, and group composition of services throughout the school year. Results Results supported that gain in PCC from pretest to posttest was predicted by several child- and therapy-level variables. Children's initial speech sound severity was negatively related to gains in PCC. Our results also supported that the total number of therapy sessions received in a year was positively predictive of PCC gain. Interestingly, the number of individual therapy sessions was negatively associated with PCC gain. Conclusion Several malleable therapy factors contribute to gains in speech sound accuracy for children with speech sound disorders. Speech-language pathologists should consider how these factors may be manipulated to best tailor treatment to the individual needs of the children on their caseloads.

Reading comprehension in dyslexic schoolchildren after an intervention program. / Compreensão de leitura em disléxicos após programa de intervenção.

PURPOSE: To develop a Speech-language Pathology (SLP) program and verify its effects on the reading comprehension of dyslexic students. METHODS: Participants were eleven 4th and 5th-grade Elementary School students, eight boys and three girls, aged 9-11 years, diagnosed with developmental dyslexia. All individuals underwent the therapeutic program, which was composed of 16 sessions divided into four levels of complexity. A text adapted according to the Cloze technique and reading comprehension and orthography tasks were used in each session. The schoolchildren had their reading comprehension assessed pre- and post-program using a text available at the Test of Reading Comprehension of Expository Texts, adapted for application of the structural Cloze technique without support, according to the Evaluation of Reading Comprehension Levels. RESULTS: The participants showed better performance in reading comprehension at the post-program assessment not only in the filling of blanks in the text adapted according to the Cloze technique and in the Responses to Reading Comprehension Questions, but also in the level of reading comprehension achieved. CONCLUSION: The SLP program improved the reading comprehension performance and increased motivation to reading of dyslexic schoolchildren. Both the Cloze technique and the Reading Comprehension Questions were useful tools to develop and identify changes in the reading comprehension of the students assessed. This study is relevant because it prepared and verified the effects of a specific remediation program for schoolchildren with dyslexia by proposing the use of texts adapted according to the Cloze technique combined with other various tasks of reading comprehension and orthography.

OBJETIVO: Elaborar um programa terapêutico fonoaudiológico e verificar seus efeitos na compreensão de leitura de escolares disléxicos. MÉTODO: Participaram do estudo onze escolares de 4º e 5° anos do ensino fundamental, diagnosticados com Dislexia do Desenvolvimento, com idades entre nove e onze anos, sendo oito meninos. Todos foram submetidos ao programa terapêutico fonoaudiológico com 16 sessões, divididas em quatro níveis de complexidade. Em cada sessão, foram utilizados um texto adaptado com a Técnica de Cloze e tarefas de Compreensão Textual e Ortografia. Os sujeitos realizaram avaliação da compreensão leitora no pré e no pós-teste com um texto do Teste de Compreensão Leitora de Textos Expositivos, adaptado com a Técnica de Cloze estrutural sem apoio, seguido da Avaliação dos Níveis de Compreensão de Leitura. RESULTADOS: Os sujeitos apresentaram melhor desempenho na compreensão leitora no pós-teste, tanto no preenchimento do texto adaptado com a Técnica de Cloze e nas respostas às Perguntas de Compreensão Textual quanto no nível de compreensão de leitura atingido. CONCLUSÃO: O programa elaborado gerou melhor desempenho na compreensão leitora dos escolares disléxicos e na motivação para a leitura. A Técnica de Cloze e as Perguntas de Compreensão Textual foram instrumentos úteis para desenvolver e apontar mudanças na compreensão de leitura dos sujeitos desta pesquisa. Trata-se de estudo relevante, por elaborar e verificar os efeitos de um programa específico de remediação para disléxicos, com uma proposta de aplicação de textos usando a Técnica de Cloze e aliando-a a outras tarefas diversificadas de compreensão de leitura textual e ortografia.

Rehabilitation of speech disorders following glossectomy, based on ultrasound visual illustration and feedback.

Intraoral surgery for tongue cancer usually induces speech disorders that have a negative impact on communication and quality of life. Studies have documented the benefit of tongue ultrasound imaging as a visual articulatory feedback for speech rehabilitation. This study aims to assess specifically the complementary contribution of visual feedback to visual illustration (i.e. the display of ultrasound video of target language movements) for the speech rehabilitation of glossectomised patients. Two therapy conditions were used alternately for ten glossectomised French patients randomly divided into two cohorts. The IF cohort benefitted from 10 sessions using illustration alone (IL condition) followed by 10 sessions using illustration supplemented by visual feedback (IL+F condition). The FI cohort followed the opposite protocol, i.e. the first 10 sessions with the IL+F condition, followed by 10 sessions with the IL condition. Phonetic accuracy (Percent Consonants Correct) was monitored at baseline (T0, before the first series) and after each series (T1 and T2) using clinical speech-language assessments. None of the contrasts computed between the two conditions, using logistic regression with random effects models, were found to be statistically significant for the group analysis of assessment scores. Results were significant for a few individuals, with balanced advantages in both conditions. In conclusion, the use of articulatory visual feedback does not seem to bring a decisive advantage over the use of visual illustration, though speech therapists and patients reported that ultrasound feedback was useful at the beginning. This result should be confirmed by similar studies involving other types of speech disorders.

Recast type, repair, and acquisition in AAC mediated interaction.

The present study investigated the effects of different types of recasts and prompts on the rate of repair and spontaneous use of novel vocabulary by eight children with severe motor speech disabilities who used speech-generating technologies to communicate. Data came from 60 transcripts of clinical sessions that were part of a conversation-based intervention designed to teach them pronouns, verbs, and verb inflections. The results showed that, when presented alone, interrogative choice and declarative recasts led to the highest rates of child repair. The results also showed that when children were presented with recasts and prompts to repair, the rate of repair increased. Spontaneous use of linguistic targets was significantly and positively related to conversational sequences where the adult recast was followed by child repair. These findings suggest that using different recast types and prompts to repair may be beneficial for spontaneous use of linguistic targets in this population.

Considerations for Chinese text input methods in the design of speech generating devices: a tutorial.

Millions of Chinese-speaking people who have the most severe speech disorders could potentially benefit from using Speech Generating Devices (SGDs) to help them participate in society. Entering Chinese text into computer systems is complex, and the process itself requires a translation system from the small selection set of keys to Chinese characters, thus adding to the complexities of adaptive access to computers often required by people who rely on them for spoken and written communication. This paper examines two types of input method: those relying on phonetic principles, and those relying on logographic principles. It evaluates the potential pros and cons of each input method to specific populations with complex communication needs.

Contribuições da CIF para uma abordagem integral na atenção à Saúde de Crianças e Adolescentes / Contributions of ICF to an integral approach in the Health Care for Children and Adolescents

RESUMO Objetivo: Investigar a participação e funcionalidade de crianças e adolescentes com alterações de fala utilizando a Classificação Internacional de Funcionalidade, Incapacidade e Saúde. Método: Pesquisa descritiva-analítica de abordagem qualitativa-quantitativa com 30 participantes com alteração de fala (CAF) e 30 com desenvolvimento típico de fala (DTF). Para a coleta de dados, realizaram-se entrevistas semiestruturadas com os participantes, estudo de prontuário, observação dos participantes quanto aos aspectos de fala e aplicação de questionário estruturado com os responsáveis. Os dados coletados foram utilizados para seleção de qualificadores das categorias da Classificação Internacional de Funcionalidade, Incapacidade e Saúde. Para comparação dos qualificadores entre grupos, utilizou-se o Teste Mann-Whitney, e a análise de conteúdo temática, para as entrevistas. Resultados: Os participantes do grupo CAF relataram maior grau de dificuldade do que o grupo DTF. As alterações de fala repercutiram significativamente em Funções do Corpo (articulação e fluência), Atividades e Participação (conversa, relacionamentos, realização de rotinas e lidar com estresse) e Fatores Ambientais (atitudes de familiares, amigos e conhecidos). Conclusão: Os resultados evidenciam o impacto das alterações de fala e suas implicações sociais para estas crianças e adolescentes. A CIF permitiu compreender a saúde em complexidade e integralidade, possibilitando assim o planejamento de estratégias para amenizar o impacto dessas alterações individual e coletivamente. Podendo ser base, futuramente, para a criação de políticas públicas e ações que poderão melhorar a qualidade de vida e promover a saúde dessa população.

ABSTRACT Purpose: To investigate participation, and functionality of children and adolescents with speech disorders using the International Classification of Functioning, Disability and Health (ICF). Method: Descriptive and analytical research of qualitative and quantitative approach. The sample was composed of 30 participants with speech disorders and 30 with typical speech development. For data collection, it was conducted semi-structured interviews with the participants, medical record review, observation of speech aspects' participants, and analyzed study of medical records. The collected data were used to qualify the framework codes. The Mann-Whitney Test was used for comparison between groups, and thematic content analysis for the interviews. Results: Participants with speech disorders reported more difficulties than the participants with typical speech development. Speech disorders significantly impacted on the Body Functions (articulation and fluency), Activities and Participation (conversation, relationships, carrying out the routine and handling of stress) and Environmental Factors (attitudes of family, friends and acquaintances). Conclusion: The results show the impact of speech disorders and their social consequences for these children and adolescents. The ICF allowed us to comprehend health in all its complexity and integrality, making possible to plan strategies to soften the disorders impact in an individual and collective perspective. Then, ICF can be used, in the future, for elaboration of public policies and actions that will improve the quality of life and promote the health of this population.

Compreensão de leitura em disléxicos após programa de intervenção / Reading comprehension in dyslexic schoolchildren after an intervention program

RESUMO Objetivo Elaborar um programa terapêutico fonoaudiológico e verificar seus efeitos na compreensão de leitura de escolares disléxicos. Método Participaram do estudo onze escolares de 4º e 5° anos do ensino fundamental, diagnosticados com Dislexia do Desenvolvimento, com idades entre nove e onze anos, sendo oito meninos. Todos foram submetidos ao programa terapêutico fonoaudiológico com 16 sessões, divididas em quatro níveis de complexidade. Em cada sessão, foram utilizados um texto adaptado com a Técnica de Cloze e tarefas de Compreensão Textual e Ortografia. Os sujeitos realizaram avaliação da compreensão leitora no pré e no pós-teste com um texto do Teste de Compreensão Leitora de Textos Expositivos, adaptado com a Técnica de Cloze estrutural sem apoio, seguido da Avaliação dos Níveis de Compreensão de Leitura. Resultados Os sujeitos apresentaram melhor desempenho na compreensão leitora no pós-teste, tanto no preenchimento do texto adaptado com a Técnica de Cloze e nas respostas às Perguntas de Compreensão Textual quanto no nível de compreensão de leitura atingido. Conclusão O programa elaborado gerou melhor desempenho na compreensão leitora dos escolares disléxicos e na motivação para a leitura. A Técnica de Cloze e as Perguntas de Compreensão Textual foram instrumentos úteis para desenvolver e apontar mudanças na compreensão de leitura dos sujeitos desta pesquisa. Trata-se de estudo relevante, por elaborar e verificar os efeitos de um programa específico de remediação para disléxicos, com uma proposta de aplicação de textos usando a Técnica de Cloze e aliando-a a outras tarefas diversificadas de compreensão de leitura textual e ortografia.

ABSTRACT Purpose To develop a Speech-language Pathology (SLP) program and verify its effects on the reading comprehension of dyslexic students. Methods Participants were eleven 4th and 5th-grade Elementary School students, eight boys and three girls, aged 9-11 years, diagnosed with developmental dyslexia. All individuals underwent the therapeutic program, which was composed of 16 sessions divided into four levels of complexity. A text adapted according to the Cloze technique and reading comprehension and orthography tasks were used in each session. The schoolchildren had their reading comprehension assessed pre- and post-program using a text available at the Test of Reading Comprehension of Expository Texts, adapted for application of the structural Cloze technique without support, according to the Evaluation of Reading Comprehension Levels. Results The participants showed better performance in reading comprehension at the post-program assessment not only in the filling of blanks in the text adapted according to the Cloze technique and in the Responses to Reading Comprehension Questions, but also in the level of reading comprehension achieved. Conclusion The SLP program improved the reading comprehension performance and increased motivation to reading of dyslexic schoolchildren. Both the Cloze technique and the Reading Comprehension Questions were useful tools to develop and identify changes in the reading comprehension of the students assessed. This study is relevant because it prepared and verified the effects of a specific remediation program for schoolchildren with dyslexia by proposing the use of texts adapted according to the Cloze technique combined with other various tasks of reading comprehension and orthography.

Basic smartphone-aided communication and leisure for people with extensive neuro-motor impairment and absence of speech.

BACKGROUND: Individuals with extensive neuro-motor impairment and lack of speech tend to remain passive and isolated, and to rely on others for communication and leisure. While their problems are known, only limited evidence is available about intervention tools that could help them curb those problems. OBJECTIVE: This study was aimed at upgrading and assessing a smartphone-based technology package, which was recently developed to help those individuals to independently engage in basic communication and leisure. METHODS: The study included 11 non-ambulatory participants who had no speech or functional active communication. They were provided with (a) a Samsung A3 smartphone with Android 6.0 Operating System, which was fitted with WhatsApp Messenger and programmed via MacroDroid, and (b) cards fitted with radio frequency identification (RFID) tags. By bringing those cards in contact with the back of the smartphone, the participant could start a communication event (e.g., sending a message to a friend) or activate a leisure event (e.g., a song). The smartphone would automatically read to the participant any incoming messages. RESULTS: During the baseline (i.e., when a standard smartphone was available), the participants were unable to engage in communication or leisure. Once the aforementioned technology package was introduced, the participants spent between about 65 and 85% of their session time engaging in communication and leisure. CONCLUSIONS: The smartphone-based technology package seems to be a useful tool to support basic communication and leisure in individuals like those involved in this study.